Falls prevention education for neurological inpatients with communication support needs: A scoping review

Objectives Falls are a leading cause of preventable harm among patients with neurological conditions. A substantial proportion of this population have communication support needs, which can hinder their ability to engage with fall prevention strategies. Despite this, they are frequently excluded from clinical interventions and related research. This scoping review aimed to identify and map hospital-based fall prevention interventions for this population. Methods Searches were conducted in Ovid MEDLINE, EMBASE and CINAHL using terms related to falls, neurological conditions, and communication. Studies were included if they involved adult inpatients with neurological diagnoses and communication support needs, and described fall prevention interventions with a patient facing communication component. Studies based in outpatient or residential aged care settings and those lacking a communication focus were excluded. Interventions were categorised as single or multifactorial, and communication components were analysed by mode, content, delivery, and tailoring to communication support needs. Results Nine hundred and ninety-five records were screened in Covidence, only one publication described patient-education fall prevention tailored to a neurological population with communication support needs. A post-hoc decision was made to include an additional 18 publications that targeted inpatients with neurological conditions but did not include information specific to communication support needs. Most interventions relied on standardised verbal education delivered by clinicians, with limited evidence of individualisation for communication needs. Reporting on intervention effectiveness was inconsistent, with few studies measuring and reporting processes and outcomes for neurological patients with communication support needs. Conclusions Falls prevention research rarely addresses the communication support needs of neurological inpatients. This review highlights a critical gap and calls for more consideration of communication support needs in intervention design and reporting. Practice Implications Falls prevention should embed communication accessibility for equitable and effective hospital care, and research should prioritise inclusive intervention design and transparent reporting of communication-related participants characteristics.